Longer-term GP training in Aboriginal Medical Services: what works and why it matters

A recent commentary in the Australian Journal of Rural Health (2026, Volume 34, Article e70194) explores an important question for rural health in Australia: how can we build a more stable and effective general practice workforce in Aboriginal Medical Services (AMSs)?

The article, “Optimising Longer-Term Training for General Practitioners in Rural Aboriginal Medical Services,” is authored by Dr Patrick Giddings, Dr Belinda O’Sullivan, A/Prof Matthew McGrail, Prof Marlene Drysdale, Dr David Baker, and Veeraja Uppal. It reflects on more than a decade of experience from the Remote Vocational Training Scheme (RVTS) and draws on findings from an independent evaluation of the program.

At the heart of the discussion is a simple but significant idea: longer training placements—typically three to four years in the same rural AMS—can make a real difference to both doctors and communities.

Why rural AMS training needs a different approach

Aboriginal Community Controlled Health Organisations (ACCHOs) and their medical services play a critical role in delivering culturally safe, comprehensive healthcare to First Nations communities. However, many of these services struggle with a persistent challenge: workforce instability.

In many rural and remote areas, care is often delivered by short-term trainees, locum doctors, or recently arrived international medical graduates. While these clinicians are essential, frequent turnover can disrupt continuity of care and make it harder to build long-term, trust-based relationships with patients and communities.

The authors highlight that this is particularly significant in First Nations health, where continuity, cultural understanding, and trust are central to effective care.

The RVTS model: training built on continuity

The Remote Vocational Training Scheme (RVTS) offers a different model. Instead of rotating through multiple placements, trainees can remain in a single AMS for 3–4 years of continuous training, supported through remote supervision, structured education, and cultural mentoring.

By 2023, the program had enrolled 71 doctors in its AMS stream. Of those who had completed training, many stayed in their communities for years afterward, suggesting that longer-term placement can support retention as well as training outcomes.

A key feature of the model is that it combines:

• Remote clinical supervision (to overcome workforce shortages in rural supervision)
• Regular structured learning and workshops
• Cultural mentoring from local First Nations community members
• A focus on selecting trainees who are well-suited to rural, relationship-based care

Together, these elements aim to support not just clinical competence, but also confidence, cultural safety, and connection to community.

What the evidence suggests

The commentary draws on evaluation data showing several important patterns:

• Trainees in longer placements are able to build deeper relationships with patients and communities
• Many remain in the same location after training, supporting workforce retention
• Continuity of care improves when doctors stay longer in one service
• Cultural mentoring helps strengthen culturally safe practice
• However, recruitment and retention can still be challenging, particularly if trainees are not well-matched to the setting or lack sufficient support

The authors also note that withdrawal rates in the AMS stream are higher than in some other training pathways, highlighting the importance of careful selection, clear expectations, and strong organisational support.

Why this matters

The broader message of the article is that training design is workforce design. How we structure GP training directly influences where doctors work, how long they stay, and the quality of care communities receive.

For rural Aboriginal Medical Services, longer-term training offers several potential benefits:

• Greater continuity of care for patients
• Stronger doctor–community relationships
• Improved cultural understanding and safety
• Better long-term workforce stability

However, the authors emphasise that these outcomes depend on more than just time spent in a placement. Success also relies on appropriate funding models, supportive supervision structures, and alignment between training organisations and community-controlled health services.

Looking forward

The commentary concludes that expanding longer-term training opportunities in AMSs could be a practical step toward improving rural and First Nations healthcare outcomes. It suggests that with the right support systems in place, programs like RVTS offer a workable model for building a more stable, skilled, and culturally responsive rural medical workforce.

In a system where continuity is often hard to achieve, this approach shows that keeping doctors in one place longer may be one of the simplest ways to improve care where it is needed most.

Read the full article HERE…

RVTS – Growing and sustaining doctors in rural, remote and First Nations communities

Volume 221, Issue 7 Supplement | The Medical Journal of Australia (mja.com.au)

Learn more about the positive findings from the recent external evaluation of the Remote Vocational Training Scheme investigating the value of program outcomes and the effectiveness of its remote supervision and support model.

The culmination of six months of detailed work by the evaluation team led by Dr Belinda O’Sullivan and A/Prof Matthew McGrail (The University of Queensland), provides a strong evidence base on which to build a continuing and expanded role for the organisation beyond 2025.

The wealth of qualitative and quantitative data has informed five articles shared in the MJA supplement.  There is an accompanying editorial commentary at: Growing and sustaining doctors in rural, remote and First Nations communities | InSight+ (mja.com.au)

Having delivered GP training to more than 500 doctors in over 350 communities, with over 300 program completions to date, the RVTS has over the past 25 years, continuously provided medical workforce solution for Australia’s rural, remote, and First Nations communities.

The evaluation has provided many insights into RVTS’ performance against its objectives and revealed many exceptional aspects of the program that are unique in the environment in which RVTS operates. Key findings include: high levels of participant satisfaction; high levels of fellowship attainment; impressive workforce retention; and comparative cost-effectiveness.

Additionally, the RVTS provides a template for best practice in the support of overseas trained doctors and showcasing place-based, retention-focused workforce strategies.

The Department of Health and Aged Care (DoHAC), funded and supported the evaluation, in the spirit of disseminating outcomes and informing ongoing quality improvement in support of services for remote and First Nations communities.

We thank the Project Reference Group and the evaluation participants, including the Remote Vocational Training Scheme (RVTS) staff, supervisors, training coordinators, medical educators, registrars, board, employers, and stakeholders who gave up their valuable time to contribute insights. This evaluation would not have been possible without their contribution.

The Stakeholder Advisory Group of Prof Jenny May, A/Prof Susan Wearne, Mr Murray Newman, Ms Carla Taylor, Ms Jo-Anne Chapman, Ms Marita Cowie, Mr David Glasson, Dr James Brown, Dr Yann Guisard, Dr Simone Raye and Ms Peta Rutherford contributed policy and program insights which informed further analysis and implications.

Additional experts and researchers who contributed to theory development included Dr Greg Gladman, Dr Karin Jodlowski-Tan, Dr Taras Mikulin, Dr Murray Towne, Dr Tiana Gurney and Dr Ronda Gurney.

Read the full article HERE…

Abstract

New Research Highlights Scalable Solution for Retaining Doctors in Rural and First Nations Communities

A new article has just been published in Frontiers in Medicine, shedding light on a powerful, scalable model for improving healthcare access across Australia’s most remote regions. Titled “Retention of doctors in remote, rural and First Nations communities using distributed general practice education: a scalable solution,” the research addresses a longstanding challenge in rural healthcare: how to attract—and retain—general practitioners where they are needed most.

Coauthored by Dr. Pat Giddings, CEO of the Remote Vocational Training Scheme (RVTS), Mathew Richard McGrail, Senior Researcher at the University of Queensland, and Dr. Belinda O’Sullivan from Monash University, this study explores how distributed models of GP education can help ensure more consistent medical care in underserved areas.

The findings highlight that delivering general practice education directly within rural and remote communities—rather than requiring doctors to relocate for training—creates strong professional and personal ties that increase the likelihood of long-term retention. This approach is particularly impactful in First Nations communities, where continuity of care and culturally competent practice are critical.

This groundbreaking research marks a major advancement in medical education policy and practice. By presenting a model that is not only effective but also scalable, the authors offer a tangible path forward for governments, training bodies, and healthcare systems aiming to improve equity in healthcare access across Australia.

Want to learn more about this important step in rural health innovation?
Read the full article here on Frontiers in Medicine